| NPI | 1124088448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA01239) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA17443) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2007-10-24 |